Rescue squads consider charging for services, as struggle to make ends meet becomes more difficult

LAMBERTVILLE — Pat Pittore didn’t want to switch, but he had no choice.

After relying on town contributions and private donations for more than a century, the ambulance company where Pittore is squad president faced the prospect of running out of money.

Having provided services for free for its entire history, the Lambertville-New Hope Ambulance Rescue Squad this month finally caved and moved to a third-party billing system that charges patients’ insurance companies an average of $600 per rescue.

“I’ve been a volunteer for over 45 years, and it was very painful, actually, to have to come to that decision,” Pittore said. “But after looking at the other squads and seeing that their income is able to sustain them, and they can plan for the future fairly accurately with a strong and steady stream of income, it just made sense.”

The Hunterdon County unit followed a number of local squads that have switched to third-party billing over the years, including Ewing, Hightstown, Princeton and West Windsor. First aid squads that provided services for free were once widespread in New Jersey.

The financial problems faced by emergency medical services that do not charge patients have been exacerbated by the recession, said Frank Setnicky, president of the Princeton First Aid and Rescue Squad. His organization began billing insurers in 1980.

In Lambertville’s case, upgrades to the squad’s building, rescue vehicles and river rescue equipment threatened to push its budget into the red, prompting the change, Pittore said.

“We’re a little bit late to the game,” he said. “We probably should have been doing it a couple of years ago.”

Setnicky said Princeton switched over as its workload mounted.

“Some squads might be able to go to 1,000, 1,500, 2,000 calls a year before they have to do it,” he said. “But every organization, depending on what their base volunteer staffing is, has a breaking point.”

For Lambertville’s squad that point came at about 1,500 calls a year, Pittore said. The squad may exceed that number this year due to an increase in calls after Hurricane Irene and tropical storm Lee, he said.

But not every squad is as stressed as Lambertville’s. Some have managed to maintain enough community support to stick with the small-town tradition of free, volunteer ambulance teams.

“We do a fundraiser. If you own property, in our district, then you are going to get a fund-raising letter from us,” said Daniel W. Boone, president of the Pennington First Aid Squad. “We get some money from Hopewell Township, and some money from Pennington Borough, and from bequests.”

About 10 miles southwest of Lambertville, the smaller Pennington organization continues to provide service without billing patients’ insurance.

“I am not going to say that we do superbly, because, yes, we have seen our donations declining. But we are surviving,” Boone said.

He conceded that Pennington’s services may not remain free forever.

“Is it going to happen in the future? It’s possible, because it’s also hard to get volunteers, people who can say, ‘Oh yeah, I can ride that time, and I’ll be there,’” he said. “They’re all getting pinched for time.”

Non-billing EMS squads such as Pennington’s can get help paying for volunteer training from the state’s EMT Training Program.

The number of squads eligible for funding has slipped into the minority in Hunterdon County, where 11 of 23 rescue teams are eligible for training funds, and in Mercer County, where 13 squads in 27 can receive aid.

Once a squad starts charging for services, it can no longer apply for state funds for training, Boone said.

“I don’t know of any squad that has started to charge for their services, and then went back to being volunteers,” Boone said, “Once they do it, they’re gone.”